Individual provider Active NPI

Geraldo Bandel, MD

  • Emergency Medicine Physician
  • Hialeah, FL
National Provider Identifier
1356320808
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0079654 Issued in FL
Practice address
1475 W 49TH St
Emergency Department
Hialeah, FL 33012-3222
Phone
(305) 558-2500
Fax
(305) 826-9002
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0079654 FL Primary

Addresses

Primary practice location

1475 W 49TH St
Emergency Department
Hialeah, FL 33012-3222

Mailing address

1475 W 49TH St
Hialeah, FL 33012-3222
Phone (305) 558-2500

Other identifiers 2

IdentifierTypeStateIssuer
06577OtherFLBCBS
268828000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421001888 FL Practitioner - Internal MedicinePractitioner - Emergency Medicine 3072509405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Small Hospital Innovations LLCGroup PAC ID 0840415444, 95 clinicians

Practice addresses (Care Compare)

524 W Sagamore Ave
Clewiston, FL 33440-3514
Phone (863) 983-9121

Hospital & facility affiliations

  • Hendry Regional Medical Center Hospital, Clewiston, FL, CCN 101309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0079654FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Small Hospital Innovations LLC Emergency Medicine CurrentSince May 15, 2015 Accepting new patients
Shi Keys LLC Emergency Medicine CurrentSince Dec 15, 2020 Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

524 W Sagamore Ave
Clewiston, FL 33440
Phone (800) 494-3984

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

3301 Overseas Hwy
Marathon, FL 33050
Phone (305) 743-5533

91500 Overseas Hwy
Tavernier, FL 33070
Phone (305) 434-3000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1356320808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 W 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123222",
            "telephone_number": "305-558-2500",
            "fax_number": "305-826-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 W 49TH ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123222",
            "telephone_number": "305-558-2500",
            "fax_number": "305-826-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDEL",
        "first_name": "GERALDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0079654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "06577",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268828000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.